Individual provider Active NPI

Oluwadamilola F Ojutalayo, MD

  • Interventional Cardiology Physician
  • Salem, MA
National Provider Identifier
1932411485
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
277503 Issued in MA
Practice address
81 Highland Ave
Salem, MA 01970
Phone
(978) 741-1200
NPI assigned
Jul 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 289987 NY
Interventional Cardiology Physician 207RI0011X 277503 MA Primary

Addresses

Primary practice location

81 Highland Ave
Salem, MA 01970

Mailing address

4820 W Taft Rd Ste 209
Liverpool, NY 13088-2806
Phone (315) 448-6215

Other practice location 1

4820 W Taft Rd Ste 209
Liverpool, NY 13088
Phone (315) 448-6215

Other practice location 2

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181213001733 MA Practitioner - Cardiovascular Disease (Cardiology) 0648589374 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Jun 1, 2020 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Feb 14, 2019 Accepting new patients
The General Hospital Corporation CurrentSince Feb 14, 2019 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Cardiovascular Disease CurrentSince Jan 1, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 1, 2020 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

70 East St
Methuen, MA 01844
Phone (978) 682-1906

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: ojutalayo.oluwadamilola.nsmc@direct.partners.masshiway.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1932411485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 W TAFT RD STE 209",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130882806",
            "telephone_number": "315-448-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-741-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4820 W Taft Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "13088",
            "country_code": "US",
            "telephone_number": "315-448-6215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-726-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OJUTALAYO",
        "first_name": "OLUWADAMILOLA",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "289987",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MA",
            "license": "277503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.